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Ann Thorac Surg 1983;36:524-528
© 1983 The Society of Thoracic Surgeons

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Articles

The Importance of One-Stage Median Sternotomy and Retroperitoneal Node Dissection in Disseminated Testicular Cancer

Department of Surgery, Division of Thoracic Surgery, Department of Medicine, Section of Oncology, and Department of Urology, Indiana University School of Medicine, Indianapolis, IN

^* Address reprint requests to Dr. Mandelbaum, Department of Surgery, Indiana University Medical Center, Indianapolis, IN 46223

More than 350 patients with testicular germ cell cancer have been treated with cisplatin combination chemotherapy. Seventy-two with metastases to the thorax who had operation are discussed here. In a subgroup of 24 patients with additional retroperitoneal disease, a one-stage median sternotomy was performed in 18 patients, and a thoracotomy in 6, with retroperitoneal node dissection. Seventeen patients had similar pathological lesions in the thorax and retroperitoneum; in 7, the lesions differed. There was no operative mortality in the entire group.

Overall, chemotherapy altered the metastases to mature teratoma in 28 patients, and 27 are long-term survivors. Among 22 patients with fibrotic, necrotic masses, 19 are long-term survivors; 6 of the 22 with persistent carcinoma had chemotherapy postoperatively and are long-term survivors.

The overall cure rate for patients with disseminated testicular cancer is approximately 80%. Among those who had a one-stage thoracoretro-peritoneal procedure, long-term survival is 83%; for the entire thoracic surgical group, it is 74%.

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